<div  id="registration_div_edit"  style="display:none">
	<div id="rightside" class="full_size">
    		<article>
        	<header><h2>Manage My Profile</h2></header>
            <div class="group" id="createDiv">
                <div class="lblDiv">Full Name: <span>*</span></div>
                <div class="cntrlDivBig">
                	<select name="" id="" class="small_ddl">
                    	<option value="">Mr.</option>
                        <option value="">Miss</option>
                        <option value="">Dr.</option>
                    </select>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                    <input type="text" name="" id="fname"  placeholder="First Name" />&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
                    <input type="text" name="" id="lname" placeholder="Last Name" />
                </div>
                <div class="lblDiv">E-mail: <span>*</span></div>
                <div class="cntrlDiv"><input type="text" name="" id="username" disabled /><span id="username_avl_status" ></span></div>
                <div class="lblDiv">Confirm E-mail: <span>*</span></div>
                <div class="cntrlDiv"><input type="text" name="" id="username_confirm" disabled/></div>
                <div class="lblDiv">Password:</div>
                <div class="cntrlDiv"><input type="password" name="" id="password" /></div>
                <div class="lblDiv">&nbsp;</div>
                <div class="cntrlDiv">&nbsp;</div>
                <div class="lblDiv">Address: <span>*</span></div>
                <div class="cntrlDivBig"><input type="text" class="txtBoxBig" name="" id="addr_line1" placeholder="Street Address" /></div>
                <div class="lblDiv">&nbsp;</div>
                <div class="cntrlDivBig"><input type="text" class="txtBoxBig" name="" id="addr_line2" placeholder="Street Address Line 2" /></div>
                <div class="lblDiv">&nbsp;</div>
                <div class="cntrlDivBig"><input type="text" class="txtBoxBig" name="" id="addr_line3" placeholder="Street Address Line 3" /></div>
                <div class="lblDiv">&nbsp;</div>
                <div class="cntrlDiv"><input type="text" name="" id="city" placeholder="City" /></div>
                <div class="lblDiv">&nbsp;</div>
                <div class="cntrlDiv"><input type="text" name="" id="state" placeholder="State / Province" /></div>
                <div class="lblDiv">&nbsp;</div>
                <div class="cntrlDiv"><input type="text" name="" id="zip" placeholder="Postal / Zip Code " /></div>
                <div class="lblDiv">&nbsp;</div>
                <div class="cntrlDiv">
                	<select name="" id="country">
                    	<option value="">Select Country</option>
                        <option value="">United States</option>
                        <option value="">Others</option>
                    </select>
                </div>
                <div class="lblDiv">Phone Number:</div>
                <div class="cntrlDiv">
                	
                	<input type="text" class="txtBoxTiny" name="" id="areaPhone" placeholder="Area" /> - 
                    <input type="text" class="txtBoxSmall" name="" id="phoneNumber" placeholder="Phone Number" />
                </div>
                <div class="lblDiv">FAX:</div>
                <div class="cntrlDiv">
                	<input type="text" class="txtBoxTiny" name="" id="areaFax" placeholder="Area" /> - 
                    <input type="text" class="txtBoxSmall" name="faxNumber" id="" placeholder="Fax Number" />
                </div>
                <div class="halfDiv">
                	<div class="lblDiv">Delivery<br/>Information:</div>
                    <div class="cntrlTextarea"><textarea name="" id="deliveryNote"></textarea></div>
                </div>
                <div class="halfDiv">&nbsp;</div>
                <div class="btnDiv">
                	<div class="lblDiv">&nbsp;</div>
                	<div class="cntrlDivBig"><input onclick="javascript:tn_updateUserProfile();" type="submit" name="" id="" value="Update My Profile"></div>
                </div>
            </div>
       		</article>
         </div>
    </div>